Bob Saal enjoys talking about his weight loss and is focused on helping others to succeed, since losing 266 pounds through surgery and diet and exercise. / Carrie Hutton/Gannett Central Wisconsin Media

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Photo taken of Bob Saal and his wife when he weighed more than 440 pounds. / Submitted photo

Bob Saal holds up his previous size pants and celebrates during the Baggy Fashion Parade during Wisconsin State Recognition Days at The Plaza Hotel in Wausau May 17. / T'xer Zhon Kha/Gannett Central Wisconsin Media

Wayne Vandenlangenberg, right, of Appleton, holds up his previous size pants during the Baggy Fashion Parade during Wisconsin State Recognition Days at The Plaza Hotel. / T'xer Zhon Kha/Gannett Central Wisconsin Media

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Holding up his previous sized pants — with a 68-inch waist band — you could see the pride on the face of Bob Saal as he stood in front of a statewide conference for Taking Off Pounds Sensibly in Wausau. Saal, 55, was honored on May 18 for the most weight loss in Division 9, among others who also lost weight in TOPS after gastric bypass surgery.

The Park Falls man is now maintaining his healthy 191 pounds, down from 457 at his heaviest weight.

The Baggy Fashion Parade at TOPS was a celebration of pounds lost and confidence and health gained. Saal turned to gastric bypass, a weight loss surgery of the stomach and small intestine, when he developed a life-threatening skin infection and spent 10 days in the hospital. He was in the operating room at Ministry St. Michael’s Hospital in Stevens Point two weeks later to surgically remove 140 pounds in March 2012.

Saal was a chef for 32 years both in and outside of Wisconsin. He’s had to change his relationship with food, because he grew up on meat and potatoes and big portions. And although it was a loving gesture by his wife, he threw out the first home cooked meal she made for Bob after surgery. He eats small portions of healthy foods and protein shakes. Gone from his meals are deep fried foods, pasta and bread.

The rest of the weight came off by taking four- to six-mile daily walks, weightlifting, swimming and running.

“There is time for exercise and eating right,” he said. Saal allows himself a free day once a month and enjoys the occasional small ice cream cone.

With a gleam in his eye, Saal talked about how he has since helped inspire others, even strangers, to lose weight.

“I show my pants off to a lot of people,” he said.

The Journal of the American Medical Association recently published a study last month that touted the benefits of gastric bypass surgery along with lifestyle and medical management for Type 2 diabetics. Participants in the gastric bypass group required three fewer medications and lost 26.1 percent of their weight compared with those who used lifestyle management techniques for diabetes treatment.

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Bariatric surgeon Dr. Steve Weiland at Aspirus Wausau Hospital said the gastric bypass is so effective for Type 2 diabetics, because it changes hormone production and the production of certain proteins on the body that can affect how we control our blood sugar. He’s aware of studies under way to test whether gastric bypass might even help treat the disease in normal weight patients. And Weiland said he has seen plenty of other health benefits to his patients, besides weight loss.

His patients have reported improvement in blood pressure, reflux disease and sleep apnea. Two years out from the surgery, Weiland said, he’s had patients running in 5-kilometer and 10-kilometer races or active hikers.

Saal is no longer on the 11 medications he had been taking for various health problems and was able to give up his breathing machine for the sleep apnea he used to have.

He’s enjoying many things others might take for granted such as playing with his eight grandchildren and tying his own shoes.

The ideal candidate is someone who is 100 pounds over their ideal body weight with a body mass index of 40, or 35 with associated health problems. Weiland said the most successful patients are “very motivated to make lifestyle changes” including changing eating habits and exercise. Because the procedure is now laparoscopic, instead of requiring a large incision in the body, recovery time is just one to two days in the hospital after the surgery.

Surgical techniques have been refined and complication rates have come way down.

“These operations have become very safe surgeries, with a low risk for death,” Weiland said.

However, Weiland said weight loss surgery alone is not going to get all the weight off.

“It’s a matter of changing your habits to eat more appropriately, eating at intervals and adding in exercise,” he said.

Patients are matched with a dietician, psychologist and physical therapist to give them the knowledge they need to maintain new healthier lifestyles after surgery.